CITY OF VESTAVIA HILLS VESTAVIA HILLS LIBRARY IN THE

CITY OF VESTAVIA HILLS

CITY OF VESTAVIA HILLS

VESTAVIA HILLS LIBRARY IN THE FOREST (VHLF)

1221 Montgomery Highway, Vestavia Hills, AL 35216

Phone: 205.978.0155 Fax: 205.978.0156

www.vestavialibrary.org

Application for Employment

PLEASE PRINT OR TYPE AND ANSWER EACH QUESTION FULLY AND ACCURATELY.

Date _______________

Name_____________________________________________________________________________

(Last) (First) (MI)

Address __________________________________________________________________________

(Street) (City) (State) (Zip)

Phone Numbers Home ________________________ Cell ________________________

Work ________________________ Other _______________________

Social Security Number (required for background check) ______________________________

Drivers License #, State of Issue (required for background check) ____________________________

Email Address _________________________________________

Position Desired ________________________________________

Have you ever filed an application for employment with VHLF before? ______

If yes: Month and Year: ___________

Have you ever been employed with VHLF before? ______

If yes: Month and Year: ___________

Are you currently employed? ______

On what date would you be available to work? ____________

Are you available to work (please circle): Full-time Part-time Temporary

Are you legally eligible for employment in the United States? ________

EDUCATION

Type of School	Name of School and Location	Course of Study	Years Completed	Diploma / Degree
High School
College
Graduate
Other (Please specify)

PREVIOUS EMPLOYMENT

Begin with current or last employer. Complete this section even if you plan to attach a resume.

Employer’s name, address

and telephone number

Dates

Employed

Hours Salary Rate

Reason for Leaving

MO/YR

From

Start

End

List Your Job Duties and Responsibilities

Position/ Job Title _____________________________________________________________

Supervisor’s Name and Contact Information________________________________________

Employer’s name, address

and telephone number

Dates

Employed

Hours Salary Rate

Reason for Leaving

MO/YR

From

Start

End

List Your Job Duties and Responsibilities

Position/ Job Title _____________________________________________________________

Supervisor’s Name and Contact Information________________________________________

Employer’s name, address

and telephone number

Dates

Employed

Hours Salary Rate

Reason for Leaving

MO/YR

From

Start

End

List Your Job Duties and Responsibilities

Position/ Job Title _____________________________________________________________

Supervisor’s Name and Contact Information________________________________________

Employer’s name, address

and telephone number

Dates

Employed

Hours Salary Rate

Reason for Leaving

MO/YR

From

Start

End

List Your Job Duties and Responsibilities

Position/ Job Title _____________________________________________________________

Supervisor’s Name and Contact Information________________________________________

Please indicate by number which supervisors you do not want us to contact. ________

ADDITIONAL REFERENCES

Please list any references you feel would be able to give information pertinent to this position. Please do not list former employers or relatives.

Reference Name

Relationship

Complete Address

Telephone

Years Known

Reference Name

Relationship

Complete Address

Telephone

Years Known

Reference Name

Relationship

Complete Address

Telephone

Years Known

The Vestavia Hills Library in the Forest is an Equal Opportunity Employer. As an Equal Opportunity Employer, decisions to hire and promote are made to qualified persons without regard to race, religion, age, sex, national origin, disability, or any other classification as prescribed by federal, state or local law. All statements made by applicants for employment will be carefully checked for accuracy. The use of this form does not in any way indicate that there are positions open and does not obligate the Library in any way.

APPLICANT’S VERIFICATION, AUTHORIZATION, AND AGREEMENT

Please read this statement before signing your application:

The information I have provided in this application for employment to the Vestavia Hills Library in the Forest (employer) is true, correct and complete. I understand that false, incomplete or misrepresented information of any kind, will be sufficient cause for my application to be rejected, or, if discovered after I am employed, cause for immediate termination of my employment.

I authorize the employer (or its agent) to contact and obtain information about me from previous employers, educational institutions and references I have provided, and any other party necessary to verify the accuracy of information I have provided in this application, a related employment resume or a personal interview. I further authorize the employer to request a report concerning my background, references, character, past employment, education, motor vehicle records, and criminal or police records, including those made by both public and private organizations.

I waive, release, and discharge any claims or actions that I may otherwise have against the employer or any person, firm, or corporation that solicits, provides, or evaluates information in connection with my employment application.

I agree to participate in a drug screening test (at the employer’s expense) as a condition to my application for employment being considered and, if hired, to participate in random drug testing as may be requested or required by the employer during the course of my employment. I understand that a positive test result may adversely affect my eligibility for employment or continued employment.

If hired, I agree to abide by the policies, rules, and regulations of the Vestavia Hills Library in the Forest. I also understand that, if hired, any employment is subject to modification or termination at any time in the sole discretion of the employer.

Applicant’s Signature____________________________________________ Date ___________________________

Please return application via email to Loraine Ward-Ryce at [email protected]. Completed applications remain active and on file for thirty days after submission.

Vestavia Hills Library in the Forest Employment Application Page 4

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